| NPI | 1477889210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIMI G DONOHUE Executive Director 707-571-2215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children (Licence: CA 490105716) |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2011-06-03 |